Hand Hygiene Fear Factor
I'm a creature of habit. So everyday after work I head to Gold's Gym. Wanting to kill two birds with one stone tonight, I decided to take an article with me to read on the bike. I chose a new paper on hand hygiene since in my biweekly meeting with our CMO today he asked me what we could do to increase hand hygiene compliance among physicians. We seemed to have plateaued at around 70% while other healthcare workers are doing much better. So the paper by Nicol et al in this month's Journal of Hospital Infection seemed appealing. It's a paper that examines the psychology of hand hygiene using semi-structured interviews. Now qualitative research is not my gig, but once on the bike my choice was either this paper or CNN (which was hyping C. diff), so I stuck with the paper.
The crux of the paper is that individuals have various levels of predisposition to hand hygiene, which is influenced by numerous factors, such as repetition during training, role modeling and institutional culture. However, the most important factor influencing the predisposition to hand hygiene was direct vivid experience, such as personal involvement in an outbreak. Of course, translation of intention to actual behavior is influenced by situational factors, such as convenient placement of alcohol products, visible soiling of the hands, smells, signs and posters. The authors conclude that vivid vicarious experiences might improve hand hygiene, but somehow I don't think that showing surgeons scary pictures will do the trick. Figuring out how to get doctors to wash their hands remains the greatest enigma in healthcare epidemiology. It drove Semmelweis crazy. And 150 years later, many of us are following in his footsteps.
The crux of the paper is that individuals have various levels of predisposition to hand hygiene, which is influenced by numerous factors, such as repetition during training, role modeling and institutional culture. However, the most important factor influencing the predisposition to hand hygiene was direct vivid experience, such as personal involvement in an outbreak. Of course, translation of intention to actual behavior is influenced by situational factors, such as convenient placement of alcohol products, visible soiling of the hands, smells, signs and posters. The authors conclude that vivid vicarious experiences might improve hand hygiene, but somehow I don't think that showing surgeons scary pictures will do the trick. Figuring out how to get doctors to wash their hands remains the greatest enigma in healthcare epidemiology. It drove Semmelweis crazy. And 150 years later, many of us are following in his footsteps.
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